What is Neuropsychology?

Neuropsychologist measure aspects of voluntary cognitive, or brain functioning through the use of a variety of objective standardized tests. The use of such tests makes it possible to compare the individual's functioning in specific areas statistically to that of other individuals of similar age and educational levels.

The analysis of the pattern of test data provided by neuropsychological assessment can provide evidence of abnormal functioning, or deficits that may be due to brain damage due to injury or disease, and/or that may be related to personality traits and psychiatric disorders. An analysis of the ways in which an individual's pattern of test findings are similar or dissimilar to those of other persons who have suffered comparable injuries, disabilities or diagnoses, makes it is possible to draw conclusions about the likelihood of the plaintiff's claims about loss of cognitive functioning and emotional distress, or fitness to function at work or in legal proceedings.

The domains that may be assessed in a neuropsychological assessment include intellectual ability (I.Q.), executive functioning (higher order problem solving, concept formation, planning and organization, mental flexibility, focused attention, inhibition or filtering of responses and impulse control), memory, academic skills, visual-motor, sensory motor and fine motor skills, as well as adaptive functioning, or daily living skills and competency. In addition, neuropsychologists typically assess personality and psychological functioning and include measures that provide evidence of atypical responses, degree of effort in responding and malingering of symptoms or memory functioning.

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What Is Forensic Psychology

Forensic Psychology is the application of the science of psychology to legal issues. The word "forensic" comes from the Latin word "forensis", meaning “of the forum” and relates the Forum in ancient Rome where the earliest courts were held.

The practice of Forensic Psychology is focused on the interface between psychology and the law. It is a means by which psychologists and psychiatrists apply their science and research to legal questions. In most cases psychologists and psychiatrists seek to aid the trier of fact by offering expert opinion in a court of law. When doing so they take measures to insure that the opinion they offer is as objective as possible and do not offer opinions that are merely possible. They are diligent in their practice to insure that they do not offer opinions that are subjective or speculative. Opinions are only given if they can be done with a reasonable degree of psychological or medical certainty.

Psychologists and Psychiatrists have been long accepted as experts by the courts. They apply their trade in a number of legal matters in both criminal and civil law.

Criminal law issues frequently addressed include:

• Sanity
• Criminal Responsibility or Mens Rea (guilty mind)
• Trial Competency
• Waiver of Miranda rights
• Death penalty mitigation
• Battered Woman Syndrome
• Domestic Violence
• Drug Dependence
• Sexual disorders

Civil law issues frequently addressed include:

• Personal Injury including psychological injuries and brain injuries
• Child custody
• Employment discrimination
• Sexual harassment
• Mental disability
• Product liability
• Professional malpractice
• Civil commitment
• Guardianship
• Workers compensation
• Psychological Autopsies

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Assessing the Truth: How Forensic Psychiatrists & Psychologists Evaluate Litigants

Forensic psychiatrist Mark Levy MD and forensic neuropsychologist Ronald Roberts, PhD co-authored an article for San Francisco Attorney Magazine, Spring, May 2008. In it, they explain the process and methods used by forensic behavioral experts when conducting an evaluation of an individual as part of a legal proceeding. Download a pdf version of the article here.

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Overcoming Obstacles to the Independent Examination of Emotional Damages Defense

Comment
Spring 2004
by Saul Rosenberg, PhD & Mark Levy, MD

Download OvercomingObstacles.pdf

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"The Last Dance" - PowerPoint Presentation on Issues of Testamentary Capacity & Allegations of Undue Influence in Will Contests

Download "The Last Dance" - Issues of Testimentary Capacity & Undue Influence in Will Contests.pdf

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MCLE Presentation Topics

The following is a list of topics about which fpamed experts can offer educational MCLE presentations:

1. "Heck of a Job!" -  The Role of Forensic Psychiatrists and Psychologists in Employment Litigation.
2. "Stressing the Point" - Posttraumatic Stress Disorder (PTSD): What it is and What it is Not.
3. PTSD - It's Role in Civil Litigation
4. Mass Tort Litigation - the Unique Role of Psychiatic and Psychological Assessment in Evaluating Group Claims of Emotional Damages.
5. Toxic Torts - the Role of a Forensic Psychiatrist and Psychologist in Evaluating Emotional Damages Associated with Toxic Torts.
6. "Subjective Disorders" - Evaluating Psychiatric and Neuropsychological Somatic "Syndromes" that Feature Subjective Complaints of Pain Without Evidence of Organic Pathology - e.g., Chronic Fatigue Syndrome, Fibromyalgia, Regional Sympathetic Dystrophy (RSD), etc.
7. "The Last Dance" - The Role of Forensic Psychiatrist and Psychologists  in Addressing Questions of Testamentary Capacity, Undue Influence and in Will Contests.
8. "Shrink on the Couch" - Depositing Mental Health Professionals.
9. The  Significance and Important Role  of Personality Disorders in Civil Litigation.
10. Boundary Violations  by Professionals (Sexual, Financial, Social) and Their Significance in Malpractice Litigation.
11. Psychiatric, Psychological and Forensic "Standard of Care" in Medical Malpractice Litigation
12. Stress in the Workplace - The Importance of Understanding Stress in Our Clients, Colleagues & Ourselves.
13. Substance Abuse - What It Is and What Is Its Role in Civil Litigation.
14. The Particular Value of Using a Forensic Child & Adolescent Psychiatrist to Assess Claims of Emotional Injury to Children.
15. The Unique Skills and Role of a Neuropsychologist in Assessing Cognitive Functioning & Impairment.
16. Child Sexual Abuse - Accurately Assessing Allegations, Its Consequences and Treatment
17. Frquent Issues Arising in Custody Battles - the Important Role of Forensic Child Psychiatric Opinion
18. Assessing the Neurocognitive  Significance Consequences of Head Injury and Traumatic Brain Injury
19. Understanding the Role, Significance and Value of Psychological and Neurocognitive Testing in Civil and Criminal Litigation

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Diagnostic Criteria for Alcohol Dependence & Abuse

The following are the diagnostic criteria for Alcohol Dependence and Abuse, asscording to the Diagnostic & Statistical Manual of Mental Disorders, Fourth Edition, Text Revised (DSM-IVTR), American Psychiatric Association, Washington, D.C. 2000.

303.90 Alcohol Dependence

Refer, in addition, to the general text and criteria for Substance Dependence. Physiological dependence on alcohol is indicated by evidence of tolerance or symptoms of Withdrawal. Especially if associated with a history of withdrawal, physiological dependence is an indication of a more severe clinical course overall (i.e., earlier onset, higher levels of intake, more alcohol-related problems).

Alcohol Withdrawal  is characterized by withdrawal symptoms that develop 4–12 hours or so after the reduction of intake following prolonged, heavy, alcohol ingestion. Because Withdrawal from alcohol can be unpleasant and intense, individuals with Alcohol Dependence may continue to consume alcohol, despite adverse consequences, often to avoid or to relieve the symptoms of withdrawal. Some withdrawal symptoms (e.g., sleep problems) can persist at lower intensities for months. A substantial minority of individuals who have Alcohol Dependence never experience clinically relevant levels of Alcohol Withdrawal, and only about 5% of individuals with Alcohol Dependence ever experience severe complications of withdrawal (e.g., delirium, grand mal seizures). Once a pattern of compulsive use develops, individuals with

Dependence may devote substantial periods of time to obtaining and consuming

alcoholic beverages. These individuals often continue to use alcohol despite evidence of adverse psychological or physical consequences (e.g., depression, blackouts, liver disease, or other sequelae).

Specifiers

The following specifiers may be applied to a diagnosis of Alcohol Dependence

With Physiological Dependence

Without Physiological Dependence

Early Full Remission

Early Partial Remission

Sustained Full Remission

Sustained Partial Remission

In a Controlled Environment

305.00 Alcohol Abuse

Refer, in addition, to the text and criteria for Substance Abuse.

Alcohol Abuse requires fewer symptoms and, thus, may be less severe than

Dependence and is only diagnosed once the absence of Dependence has been

established. School and job performance may suffer either from the aftereffects of drinking or from actual intoxication on the job or at school; child care or household responsibilities may be neglected; and alcohol-related absences may occur from school or job. The person may use alcohol in physically hazardous circumstances (e.g., driving an automobile or operating machinery while intoxicated). Legal difficulties may arise because of alcohol use (e.g., arrests for intoxicated behavior or for driving under the influence). Finally, individuals with Alcohol Abuse may continue to consume alcohol despite the knowledge that continued consumption poses significant social or interpersonal problems for them (e.g., violent arguments with spouse while intoxicated, child abuse). When these problems are accompanied by evidence of tolerance, withdrawal, or compulsive behavior related to alcohol use, a diagnosis of Alcohol Dependence, rather than Alcohol Abuse, should be considered. However, since some

symptoms of tolerance, withdrawal, or compulsive use can occur in individuals with Abuse but not Dependence, it is important to determine whether the full criteria for Dependence are met.

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